Dr. G: Medical Examiner - Season 6, Episode 11 - Deadly Circumstances - Full Episode | Forensic Files

[MUSIC PLAYING] NARRATOR: When a man is found dead outside a rundown motel, Dr. G fears the worst.
So a man down, kind of a seedy part of town, this could very well be a homicide.
NARRATOR: But during the autopsy, she discovers something so shocking she can hardly believe her eyes.
What I found was one of the most remarkable things I'd ever seen. NARRATOR: Then a teenage boy is traumatized
when he finds his father's lifeless body at the foot of their attic ladder. He's obviously devastated to find his dad dead.
NARRATOR: And now, his grief stricken family is desperate to know what took his life so suddenly.
Why him? Why that day? Why that moment? That's $1,000 question. [THEME MUSIC] NARRATOR: Altered lives, baffling medical mysteries,
shocking revelations-- these are the everyday cases of "Dr. G, Medical Examiner."
As a rule, chief medical examiner Dr. Jan Garavaglia prefers to work with as few distractions as
possible. I don't like a lot of people talking while I'm doing my autopsies. And a lot of people don't understand
that, that, you know, you're actually concentrating when you're doing an autopsy.
I'll have my gloves on. I'll have a scalpel in my hand. And I'm getting ready to autopsy,
and a detective will ask, what do you think he died from? I'm like, hold your horses.
I don't like to guess. I like to get to the answer. NARRATOR: And it will take a whole lot more than guesswork
to solve the mystery in this next case. What I found during the autopsy was one of the most remarkable things I'd ever seen.
NARRATOR: On a brisk winter morning, Hank Johnson arrives at his maintenance job
at the Blue Sky Lodge. He had gotten to work around 6:00 in the morning. And he was making his rounds.
NARRATOR: But as he's taking out the trash behind the motel, he comes upon a startling sight.
A man is lying face up on the sidewalk. And as Hank moves in for a closer look, he gets the shock of his life.
The man is clearly dead. Must've been scary. NARRATOR: Shaken, Hank immediately dials 911.
Police soon arrive on the scene, followed closely by one of Dr. G's medical investigators.
My investigator goes to the scene to be my eyes and ears. NARRATOR: And her foremost priority is to ID the body.
And in this case, there was an identification with a photo that looked just like this fellow.
NARRATOR: The mystery man now has a name-- Victor Morales, a 52-year-old Hispanic male
from St. Cloud, Florida. But outside of that, investigators have precious little to go on.
His body is transported to the District 9 morgue, and now Dr. G and her team are determined to figure
out what claimed his life. We've got a fellow down. We don't know anything about him.
So we gotta look for clues. All right, let's see here. Let's see here. NARRATOR: She begins by reading through the investigator's
report, searching for any insights into what could have led to his sudden death.
We don't have much history. Nobody's telling us much about this fellow. NARRATOR: According to the few who knew him,
Victor was a loner who lived in a nearby trailer park, until a few days earlier, when a fire destroyed his home.
He just had his home burned down and all his possessions. So he is kind of forced to go into this hotel.
But now he's dead. It sounds like terrible luck. NARRATOR: But while Victor's misfortune provides little
in the way of clues, it isn't long before Dr. G gets her first promising lead. A hotel proprietor stated that he just
checked in about two days ago and that he was kind of yellowish and kind of shaky.
The proprietor really thought he looked ill, so certainly natural disease could have played a role.
NARRATOR: Unfortunately, the vague description isn't a lot to go on. Victor could have been suffering from a myriad
of ailments, from kidney failure to heart disease. But based on the circumstances, Dr. G
can't help but wonder if the 52-year-old may have been wrestling with a dangerous addiction.
I really thought he sounded like he might have been an alcoholic. There's many ways you can die from alcohol.
And one always has to worry about drugs. NARRATOR: But there's an even more unsettling possibility--
foul play. JAN GARAVAGLIA: What's really disturbing is my investigator said he's got a small abrasion at the top of his forehead
near his hairline. So that's somewhat suspicious. A man down, kind of a seedy part of town--
one always has to worry about foul play. The police are waiting to see if this looks suspicious for homicide.
But we don't know what this is. This is truly a mystery at this point. It's just a wide open game.
We won't know until we do the autopsy. All right, let's see. Oh, wow, he looks old.
Overall, he looks a little older than 52 years old. He looks a little disheveled, and he looked ill.
NARRATOR: Given that foul play is high on her list of suspects, Dr. G zeros in on the abrasion
on Victor's head. He does have a little bit of head trauma. I don't know if somebody has hit him.
I don't know what this abrasion is all about. NARRATOR: She won't know if the injury was fatal until she
completes a full cranial exam. But as Dr. G's eyes move down Victor's body, she spots a clue that just may hold the secret
to his untimely death. You see these? Oh, jeez. Gosh. Something is going on with him.
It looks like it could very well be a homicide. NARRATOR: Dr. G has just discovered a telling clue
on the body of 52-year-old Victor Morales, who was found dead on the sidewalk outside a rundown motel.
He's got kind of scratch abrasions on his arm. NARRATOR: This, along with the abrasion on his forehead,
has moved foul play up the list of suspects. The scratches on his arm may indicate
somebody is grabbing him. So maybe there's an altercation going on. NARRATOR: But the only way to know for sure
is to look inside Victor's body. And she'll start with the head. It could be foul play.
It could have been accidental that he'd hit his head. But I need to see if we can really piece this together.
Let's see what happens when we get inside. NARRATOR: Using an oscillating saw, morgue technician Brian Machulski opens the skull.
So we go to the head really looking for trauma. But there is no evidence of bruising, no skull fractures.
There's no hemorrhage over the brain. There is no evidence of trauma. All right, he's fine.
So he's got no trauma to the head. That's what we're looking for. But there's still a possibility of broken ribs
and maybe fractured a spleen or, you know, tore the liver. So being hit or falling is still in the mix.
Clearly, I need to open the rest of the body to get my answer. OK. We do our typical Y incision from the shoulders
down to the lower abdomen and open it up. I make sure there's no free fluid in that abdominal cavity.
There's nothing in there. And there isn't any. Go ahead. I move the chest plate.
Of course I'm looking for any rib fractures, and there is none. There's nothing there.
We know that we're not dealing with trauma. NARRATOR: Dr. G can now safely rule out both foul play
and an accidental follow. But this only deepens the mystery. If he wasn't the victim of an assault,
how did he wind up in the lot behind the motel, and why all the scratches and abrasions?
Her next step is to collect blood and urine samples for toxicology. JAN GARAVAGLIA: Of course we check if there's any alcohol.
And I need to check for any type of drugs, whether it's prescription or illicit.
It's important to take tox because that might be our answer. NARRATOR: With the samples drawn,
Dr. G scans Victor's abdominal organs one by one, looking for any abnormalities.
When I look in the abdomen, everything looks pretty good. He's looking pretty good on the inside.
NARRATOR: But based on the circumstances surrounding Victor's death, there's one organ in particular
that Dr. G must examine. When I hear that he's yellow and shaky, he could be dying from liver disease.
But his liver, which I thought was going to be cirrhotic and show evidence of chronic alcohol abuse,
really didn't. Let's see what's going on here. NARRATOR: No closer to his cause of death,
Dr. G turns her attention to the organs in Victor's chest cavity. And she can see right away that something isn't right.
Oh, something's wrong with his lungs. Normally, our lung should be nice and airy,
kind of like a sponge. There's little tiny air air spaces. But when I look at his lung, the entire lower lobe
of that right lung was firm. He clearly has a bacterial infection. And this has progressed to the entire lobe and almost
solidified because so much pus is filling up those alveolar air spaces. He's got a low bar pneumonia.
NARRATOR: But Dr. G can't tell with just her naked eye if the infection was severe enough to kill him.
JAN GARAVAGLIA: It's hard to say. I will, of course, culture that, and I will, of course,
look under the microscope. All right. But the next thing I want to look at is his heart, because you always worry
about maybe a heart attack. NARRATOR: Carefully, Dr. G pierces the pericardial sac with her scalpel,
exposing the heart inside. And right away, she makes a shocking discovery. Oh, look at that.
When I open up this pericardial sac, I am absolutely floored. Wow. What I found was one of the most remarkable things
I'd ever seen. Oh, look at that. NARRATOR: Dr. G has just stumbled across a tantalizing and unusual clue inside the heart sac
of 52-year-old Victor Morales. It is the most remarkable pericardial sac I have ever seen.
It looks as if somebody took a shag rug, lined the pericardial sac, and covered the heart.
Oh my god. Look at that. He's got clearly a pericarditis, an inflammation of the sac lining the heart.
Untreated bacterial pericarditis is 100% fatal, if this is what he has. But this pericarditis is unbelievable to the point
where it's too unbelievable. So I'm a little worried about what's going on there.
Is there truly just an infection, or is there something else going on? It can be a lot of natural diseases causing it,
everything from rheumatic fever, some connective tissue diseases, or it could be from a TB or from a fungus.
I have to take micros of it. NARRATOR: Dr. G collect samples of his heart to be made into slides.
She hopes a magnified view of the tissue will help shed light on the bizarre finding.
I need to look under the microscope. What is the etiology, the cause of all this?
So I think what we're going to do is be prudent and [INAUDIBLE] until we get those micros back.
NARRATOR: As the autopsy comes to a close, so does Dr. G's day. But although she leaves the morgue,
her mind doesn't leave the case. MARK WALLACE: Dr. G brought up this case when we're
driving home from work one day. She was excited about talking to me about what this might represent.
It's always fun to talk about cases with Mark. He's a very wise fellow. He really brings out the best of you
kind of discussing it and thinking of new angles. He just thought it was a great case.
So we were interested to see what the micros would show and what the cultures would show.
NARRATOR: For three weeks, Dr. G has patiently waited for the lab experts to work their magic.
And today, the waiting game finally comes to an end. JAN GARAVAGLIA: The tox, actually, in and of itself,
didn't show anything. You know, it was negative all across. NARRATOR: She can now officially rule out a drug
or alcohol related death. Next, Dr. G slips the micros of Victor's heart and lungs underneath the lens.
And what she discovers is telling. The lining of the pericardial sac and lining of the heart
was definitely an acute infectious pericarditis. And when you look at his lungs, he clearly
has a low bar pneumonia. NARRATOR: Two severe infections, one in the lungs and one in the heart, both caused by the strep bacteria.
This confirms Dr. G's findings at autopsy. But when she zooms in on the bronchus, the main air
tube inside the lungs, she spots something that she couldn't see with her naked eye.
The bronchus inside the lungs show necrosis and some chronic inflammation. What is causing all this?
NARRATOR: And at this point, Dr. G has only one place left to look-- the viral culture report.
And when I get my culture, that's the smoking gun. All the pieces fit together. And I love that when that happens.
NARRATOR: Dr. G has just reviewed the lab results of 52-year-old Victor Morales.
And after a three-week investigation, she's finally found the missing link to a strange and sudden death.
When I get my cultures back, I have all my pieces together. And I clearly see the progression of what happened.
NARRATOR: In the winter of 2009, Victor Morales checks into the Blue Sky Lodge after a devastating fire
burns down his home. JAN GARAVAGLIA: He looked kind of yellow and kind of shaky when he checked into the hotel.
The clerk thought he looked sick. He is sick. And he's dying. NARRATOR: Thanks to the culture of Victor's bronchus,
Dr. G now knows the identity of this ruthless killer. The cultures came back positive for H1N1 influenza.
NARRATOR: H1N1, also known as swine flu, is a strain of influenza first detected in the United States
in April of 2009. In extreme cases, it can be life threatening. MARK WALLACE: It's thought that there
was about 16 million Americans who got H1N1 over the last year. Out of that, about 12,000 died.
This flu bug was different in that it didn't kill our typical demographic of the older person
with a lot of chronic diseases. You tended to see it more in young people. We saw a lot of people who were obese having a lot of problems
with it. We had pregnant women die with it. We had kids dying with it. And we even had, you know, people
52 years old dying with it. NARRATOR: Dr. G suspects that Victor contracted H1N1
about 10 days before he died. Whether someone sneezed on him or he touched the virus
and then touched his mouth or nose or eyes, that virus took hold. He started feeling sick.
He's feeling achy. He's got a headache. At this point, he could have gotten treatment,
but he didn't. NARRATOR: Not long after Victor is infected, the virus invades his airways and attacks the lining
of his bronchus, to the point where the tissue becomes irritated and dies. That lining is so inflamed, it can't do its job.
And part of its job is to help remove bacteria, get it out of the lungs. NARRATOR: Eventually, the bacteria
begins to spread from the bronchus into Victor's lungs, setting into motion a deadly chain of events.
That set him up for a serious bacterial pneumonia, which developed in his right lower lung.
JAN GARAVAGLIA: That infection, then, spreads to his pericardial sac, which sits adjacent to it.
NARRATOR: The raging infection triggers a pericarditis so severe that the heart appears to be
covered in a thick shag carpet. The pus starts developing these kind of fronds, and eventually, that bacteria goes into his blood.
NARRATOR: And once the bacteria is in Victor's bloodstream, it isn't long before it sets off a life threatening
condition called sepsis. It causes the blood pressure to drop, and eventually, he doesn't get blood to his brain, his heart.
NARRATOR: And as he staggers outside, most likely to seek help, his heart finally gives out.
And he collapsed and dies on the sidewalk. NARRATOR: Dr. G can now close the book
on the case of Victor Morales. But one question still remains. How did he get the scratches and abrasions?
JAN GARAVAGLIA: We may never know why he had the scratches on his arm and the abrasions
to his head. Oftentimes you don't know exactly what happened, and you never will.
But it's really interesting that we started out with a case that could have been homicide,
an accident, a natural, and the culprit ends up to be H1N1. NARRATOR: Dr. G immediately reports her findings
to the local authorities. When you find something like this, you contact the health department.
The health department keeps track of all the people die from the flu. All those numbers that you hear on TV,
all the statistics, all that information is gathered one case at a time. This man's death was preventable.
He didn't have to die from the flu. He could have been treated along multiple stages of his illness.
There is antiviral medication that this flu was sensitive to, and his pneumonia would have been
treated with clear antibiotics. He probably spent the last week of his life miserable.
This poor guy had no one. It's not good that people die alone. That's really the tragedy of this case.
NARRATOR: Dr. G is ultimately responsible for all cases that come through the District 9 morgue.
But she doesn't perform every autopsy herself. [INAUDIBLE] he needs to be X-rayed.
Some people think I'm the only one here. There's actually five of us. Well, if you'd get here on time--
There's five physicians that work in this office. NARRATOR: And the youngest physician on her staff
is Dr. Joshua Stephany, who first came to the morgue in 2003, when he trained as a resident
under Dr. G. He really had an inquisitive mind. He really liked the cases, and the smells didn't bother him.
So I hired Josh immediately out of his fellowship to work in our office. You know, Josh is still young.
And there's still things that he hasn't seen. And he still is learning the day-to-day.
You know what you're going to have to do, is take some micros of that. Yeah. [INAUDIBLE]
I value her input just from the experience level. She's been doing this longer than I have.
She's seen a lot more than I have. JAN GARAVAGLIA: I'm thankful for all the physicians
that work with me. We have a really good team, and it's nice to work with good people.
NARRATOR: Every morning at 8:00 AM, all five medical examiners gather to discuss the day's cases.
JAN GARAVAGLIA: It is very important to have multiple eyes and ears because one medical examiner could come up
with an idea and kind of shed a new light and a new way of thinking about a case.
NARRATOR: At the end of each meeting, the morgue workload is divvied up. And the winner of that lottery was Dr. Stephany.
NARRATOR: And today, it looks like Dr. Stephany has landed a particularly interesting case.
We all like a mystery. It's no fun to get a present when you know what's inside already.
NARRATOR: It's a Sunday morning in late June. But for Dario Romano, a ninth grade teacher,
it isn't your typical lazy weekend. He's knee deep in a home renovation project that he's been working on for weeks.
Apparently, he was working up in the attic, helping the family try to put an addition on to the attic.
NARRATOR: Nothing about the 45-year-old seems out of the ordinary. But around noon, Dario San Miguel is on his way
to the laundry room-- Dad? NARRATOR: --when he stumbles onto a terrifying scene.
Dad! He finds his father unresponsive at the bottom of the ladder. NARRATOR: In a panic, Miguel immediately dials 911.
And paramedics arrive on the scene within minutes. He had no vitals, no heartbeat, no pulse.
He wasn't breathing. NARRATOR: Emergency technicians performed CPR on Dario for over half an hour.
But despite every effort to save his life, the beloved father and husband dies right there at the foot
of his attic stairs. They couldn't bring him back. The family's very surprised, very shocked.
JAN GARAVAGLIA: It's really sad. You know, the poor 15-year-old is obviously devastated
to find his dad dead. NARRATOR: And now, it's up to Dr. Stephany to solve the mystery of Dario's tragic death.
JAN GARAVAGLIA: But we don't know why he died. But by the end of the day, we're hoping to know.
NARRATOR: Associate medical examiner Dr. Joshua Stephany is preparing for the autopsy of Dario
Romano, whose family is still reeling from their unexpected loss. JAN GARAVAGLIA: I think the worst part is that the family
just has no clue why he died. And we're hoping the autopsy gives us the answer. JOSHUA STEPHANY: Trying see what's going on with this guy.
NARRATOR: Dr. Stephany begins by reading through the detailed investigator's report.
We have a 45-year-old Hispanic male found dead at the bottom of a ladder that leads up to his attic.
I think trauma is a possibility on this fellow. NARRATOR: And a fatal head injury
is at the top of his list. He could have hit his head up in the attic, or he could have fallen coming down the ladder.
If there is trauma, there could be a buildup of blood. A buildup of blood affects you to the point
where you can pass out. NARRATOR: But Dr. Stephany must also consider a number of alternate scenarios.
It was a hot day at the end of June. JOSHUA STEPHANY: That attic can get up to 120,
150 degrees no problem. So heat stroke is a definite possibility. Heat stroke is when your body temperature
goes up, usually above 105. It's a serious condition. But that one's going to be difficult to prove because we
don't have a temperature. EMS didn't take a temperature. NARRATOR: This means that in order to record heat stroke
as Dario's official cause of death, Dr. Stephany will first have to rule everything else out.
And given the circumstances on the scene, there's another theory he must consider.
We know he's working with the power tools up there. So you're thinking, is there possible of electrocution?
JAN GARAVAGLIA: He'd been in that very hot attic, so he's probably sweating profusely.
You know, that sweat is a very good conductor of electricity. You can still move after you've been electrocuted.
So there is a chance that he started walking-- he got electrocuted, started walking down the ladder
and fell off. That's a possibility. NARRATOR: Next, Dr. Stephany leafs through the 45-year-old's medical history,
and right away, he spots an important detail. We have the history that he's got a congenital cardiac anomaly.
NARRATOR: Dario was born with a defect of the aortic valve, the opening that regulates blood flow
from the heart to the aorta. Over time, it can lead to a dangerous condition called aortic stenosis.
The aortic stenosis causes those valves to be stiff and then narrowed, letting less and less blood
get through them. And that's a huge strain on your heart. But we were told he is being followed by a cardiologist.
And up until you start getting that narrowing, there's not a really high chance you're going to die suddenly
and unexpectedly. Well, right now, if there is, given those circumstances, it's pretty much open ended.
It can be anything. He's going to let the body speak to him. Let's take a look what we've got here.
NARRATOR: Dr. Stephany begins with a meticulous examination of the body, searching for any evidence of electrocution.
We often see just little burns where the electricity goes in. They're kind of dry with raised white edges--
real classic for electrical burn. NARRATOR: With a careful eye, he studies the hands
and other extremities, on the lookout for any suspicious markings. No burn marks, no small charring
or discolorations of the body. NARRATOR: On first blush, death by electrocution is looking less likely.
However, as with heat stroke, Dr. Stephany must rule it out by diagnosis of exclusion.
But as he continues to scan the body for clues, something else immediately grabs his attention.
Oh, look at this. There are abrasions on the chest, the lower back, the shins, the knees,
and on the upper extremities. That could be from a fall, going down the ladder. You get a clean picture of that one?
NARRATOR: Now, he'll have to dig deeper for answers. And he knows just where to look first.
The number one traumatic injury for falling off a ladder would be head trauma. But you never know what you find in the head.
NARRATOR: With his scalpel in hand, Dr. Stephany slides the blade across Dario's scalp.
We'll make an incision going from the back of one ear to the back of the other ear.
Our theory is that he hit his head, that he has maybe a subdural, blood collecting over the brain.
NARRATOR: To gain access to the brain itself, he cuts through the bone with an oscillating saw.
How do you breathe in this thing? Everything's so foggy. I know. NARRATOR: Eyes peeled for any abnormalities, Dr. Stephany
inspects the surface of the organ inch by inch. But I don't see any subdural blood.
I don't see any blood around the cerebral hemispheres. Nothing here. This looks fine.
He didn't have a typical injury we see with falling off a ladder. He didn't have head trauma.
The head was not the cause of his death. JOSHUA STEPHANY: I'm not quite sure what's going on.
He's a mystery. So we really don't know what's going on with this fellow. I think it'll be interesting to see what the autopsy shows.
JOSHUA STEPHANY: We take the scalpel, make the incision from both anterior shoulders,
meet at the mid chest, and then go down the mid-abdomen. NARRATOR: Carefully, Dr. Stephany
peels back the deep layers of tissue to reveal the inside of Dario's body. And the instant the abdominal cavity is exposed,
he's completely taken aback. That's not good. This was quite shocking. NARRATOR: Dr. Stephany has just made
a stunning discovery inside the body of 45-year-old Dario Romano. That's not good.
He's quite surprised at what he finds. He's got some blood in the abdomen, so I don't know.
I see a large amount of blood in the cavity, so I want to know what's going on. First of all, I want to measure it to see how much is in there.
Let's let all this blood out. We need to measure that. We actually take a soup ladle and slowly ladle it out
like we're ladling out soup. NARRATOR: And by the time he's done, Dr. Stephany has measured out a staggering 1,700 milliliters.
That's a lot of blood. That's over a third of his blood volume. Now it's his job to figure out why has he got that blood.
Right now, I'm not really sure what the source of blood is. Is it natural disease?
Did he rupture a spleen? And what's going on in his chest? Are there rib fractures involved here?
NARRATOR: With these thoughts in mind, Dr. Stephany removes the chest plate and takes initial stock of Dario's upper body cavity.
I don't see any evidence of fractures on the ribs. I don't see any lacerations. I don't see perforations.
I need to look at his heart. NARRATOR: But given Dario's congenital abnormality,
Dr. Stephany is also eager to examine the heart. So let's see. NARRATOR: He cuts through the pericardial sac
to expose the organ inside and immediately spots something alarming. Oh, that's a big heart.
What's noteworthy right off the bat with his heart is it's enlarged. The heart weighs almost 600 grams.
That's a thick, big heart. NARRATOR: And as Dr. Stephany inspects the organ more
closely, he's surprised to see that it's in worse shape than he expected. It's clear now that Dario had developed a severe case
of aortic stenosis. JOSHUA STEPHANY: It doesn't look so good. The valve is usually beautiful.
They're very thin and delicate, but this is a gnarly looking valve. It's all diseased and narrowed and stiff and calcified.
The heart, to push out same amount of blood out through that narrow opening has to pump harder.
So because the heart's working harder, the heart is a little thickened and a little larger.
JAN GARAVAGLIA: This is a very bad heart. If not for the blood in his belly, I would have said that is probably the cause of death.
But he needs to figure out what has happened that's created 1,700 milliliters of free blood
in his abdominal cavity. So I don't know where the blood is coming from. So I want look in the abdominal cavity.
NARRATOR: One by one, Dr. Stephany begins the arduous task of removing and dissecting the abdominal organs,
starting with the GI tract. We do a look around the organs, but I don't see any perforations in the stomach, in the bowels,
in the intestines. He doesn't find anything. NARRATOR: Next, he removes the liver.
The surface of the liver looks intact. It looks nice tan brown color. Nothing remarkable.
NARRATOR: But as he cuts into the organ itself, he finally strikes paydirt. JOSHUA STEPHANY: Oh, there it is.
I see a nice big laceration of the internal surface of the liver. That tear is quite deep.
That's clearly where that blood is coming from. NARRATOR: But ironically, this discovery
only deepens the mystery. Well, to me, it was strange, you know. It's a surprising finding.
It's unusual to have a lacerated liver not related to an automobile accident and really high falls,
like off of buildings. Why did he lacerate his liver? That's the $1,000 question.
NARRATOR: As the autopsy comes to a close, Dr. Stephany still has his work cut out for him.
What is the chain of events that led to that cause of death? NARRATOR: To figure that out, Dr. Stephany
will need to go back to square one, reexamining all the evidence from the investigator's report
to the medical history to the internal and external exams. In the morning, each of the doctors
shares what they found from the autopsy from the day before. NARRATOR: And after a night of intense deliberation,
Dr. Stephany believes he can finally explain to his colleagues exactly what led to Dario Romano's tragic death.
It's a scorching hot Sunday in Winter Park, Florida, and Dario Romano is up in his attic,
laboring over a home improvement project. He was working, laying planks up there, using some electrical equipment, sawing some boards.
It's hot. It's the height of summer. The attic temperature can get easily to 120, 150 degrees.
NARRATOR: As the temperature rises, Dario's body becomes overwhelmed by the heat,
putting a dangerous strain on his already damaged heart. JAN GARAVAGLIA: The heart is really working hard
to get the blood through that narrowed opening at the aortic valve. And when he's stressing himself in that attic,
in the heat, working, that's a lot for his heart to take. NARRATOR: The organs soon goes into overdrive,
struggling to pump fresh blood and oxygen through the 45-year-old's body. That could make him dizzy.
It could make him woozy. Which led him to lose balance, causing him to fall. He must have hit his side.
He's got a nice abrasion on that right side. NARRATOR: And given the odd manner in which Dario's body
goes down, what might have been a relatively harmless fall turns into a catastrophic blow.
Unfortunately, you know, he hit just the right way to lacerate that liver. This gentleman must have fallen against something, must
have hit something with his abdomen to cause that type of laceration. JAN GARAVAGLIA: Dr. Stephany thinks he
lacerated it up in the attic. My theory is that he clearly can't get that liver laceration with a minor fall.
I don't think there's enough force up in that attic that would have caused that laceration.
I think it occurred that when he was walking down that ladder and he fell. NARRATOR: But while Dr. G and Dr. Stephany
may disagree on the exact chain of events, one thing is certain-- once the liver is lacerated, blood
begins gushing out of the wound and into the abdominal cavity at an alarming rate.
He is losing blood flow to the organs and losing blood flow to the heart. He gets himself up, sits up against that ladder to rest.
He's just slowly losing consciousness. NARRATOR: One by one, the 45-year-old's organs
begin shutting down. And within seconds, he is dead. JAN GARAVAGLIA: This is one of those cases
that you think is a sad accident. NARRATOR: In the end, no one can argue that the sequence of events leading to Dario Romano's
untimely death were unusual-- a hot day, a compromised heart, and a flukish fall.
But sadly, to Dr. G and her team, it's not an unfamiliar story. Why him? Why that day?
Why that moment? People always assume that it's one thing that kills you. And ultimately, there's many factors that play a role that
end up causing people to die. NARRATOR: Now, findings in hand, Dr. Stephany reaches out to Dario's devastated widow, Gloria.
I relayed my cause and manner of death. Let them know that there is nothing they could have done.
But I wanted to talk to her more about the aortic valve. JAN GARAVAGLIA: Dr. Stephany put extra effort-- just
make sure she understood how serious his aortic stenosis was in that there is an increased
chance her son had this. Because there is a possibility that congenital abnormality
could be genetic. You definitely want to have her get the son to see a cardiologist.
So she was thankful. Dr. Stephany handled this case great. I mean, he kept an open mind.
He let the body tell him what happened. And then he kind of sat back and thought about it
and put the pieces together. A lot of people think we don't-- you know, the people are dead.
How do we help people if all we're doing is examining dead people and [INAUDIBLE] cause of death?
This is a good example of helping a living person, helping a family.

Dario Romano is found dead by his son at the bottom of the attic ladder. What happened to this 45-year-old? With Dr. G’s guidance, Dr. Stephany must solve the mystery.

A Florida medical examiner takes viewers through puzzling cases while explaining procedures and conclusions.

Brief Summary

Two autopsies reveal unexpected causes of death: H1N1 influenza and a lacerated liver from a fall due to heart issues.

Key points

A Shocking Discovery. During the autopsy, Dr. G uncovers a remarkable finding that could explain the death.
The Cause of Death Revealed. Dr. G identifies H1N1 influenza as the cause of Victor's sudden death.
A Tragic Death. Dario Romano, a beloved father, dies unexpectedly at home, leaving his family in shock.
The Autopsy Begins. Dr. Stephany prepares to uncover the mystery behind Dario's sudden death.
A Shocking Discovery. Dr. Stephany discovers a large amount of blood in Dario's abdomen during the autopsy.
Unusual Findings. Dr. Stephany finds a lacerated liver, raising questions about the cause of death.

Episode highlights

Episode quotes

What I found was one of the most remarkable things I'd ever seen.

Dr. G's discovery during the autopsy.

0:36WatchJun 22, 2021

Tension

75/ 100High tension

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